2013 / 2014 Medicare Part D Plan Information Click here to jump to the Chart Legend | |||||||||||||||
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Plan Name | Monthly Premium |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
$0 Prem. with Full LIS? |
Plan ID |
Cost-Sharing | Total Formulary Drugs | ||||||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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-- This plan not offered in 2013 -- | S5884 -165 | ||||||||||||||
2014 Humana Walmart Rx Plan (PDP) | $12.60 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $1.00 | $4.00 | 20% | 39% | 3189 2014 Formulary | ||||||
2013 WellCare Classic (PDP) | $28.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Yes | S5967 -156 | $5.00 | $42.00 | $94.00 | 33% | 2835 2013 Formulary | |||||
2014 WellCare Classic (PDP) | $14.20 | $0 | No additional gap coverage, only the Donut Hole Discount | Yes | $0.00 | $13.00 | $39.00 | $90.00 | 2844 2014 Formulary | ||||||
2013 Humana Walmart-Preferred Rx Plan (PDP) | $18.50 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5884 -141 | $1.00 | $5.00 | 20% | 35% | 3251 2013 Formulary | |||||
2014 Humana Preferred Rx Plan (PDP) | $22.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $1.00 | $2.00 | 20% | 35% | 3043 2014 Formulary | ||||||
2013 AARP MedicareRx Saver Plus (PDP) | $15.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5921 -364 | $1.00 | $2.00 | $25.00 | $45.00 | 3282 2013 Formulary | |||||
2014 AARP MedicareRx Saver Plus (PDP) | $24.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $1.00 | $2.00 | $20.00 | $35.00 | 3219 2014 Formulary | ||||||
2013 Cigna Medicare Rx Plan One (PDP) | $33.50 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5617 -225 | $0.00 | $8.00 | $28.00 | $71.00 | 3494 2013 Formulary | |||||
2014 Cigna Medicare Rx Secure (PDP) | $28.20 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $0.00 | $4.00 | $32.00 | $67.00 | 3414 2014 Formulary | ||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 Windsor Rx (PDP) | $30.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S2505 -003 | $6.00 | $40.00 | $80.00 | 25% | 2598 2013 Formulary | |||||
2014 Windsor Rx (PDP) | $28.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $3.00 | $9.00 | $43.00 | $90.00 | 2885 2014 Formulary | ||||||
2013 HealthSpring Prescription Drug Plan-Reg 19 (PDP) | $32.70 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5932 -018 | 25% | 3027 2013 Formulary | ||||||||
2014 Cigna-HealthSpring Rx -Reg 19 (PDP) | $28.90 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | 25% | 2946 2014 Formulary | |||||||||
2013 Express Scripts Medicare - Value (PDP) | $34.50 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5660 -121 | $4.00 | $6.00 | 25% | 48% | 3381 2013 Formulary | |||||
2014 Express Scripts Medicare - Value (PDP) | $29.20 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $2.00 | $6.00 | 25% | 50% | 3171 2014 Formulary | ||||||
2013 SilverScript Basic (PDP) | $33.20 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5601 -038 | $2.00 | 25% | 50% | 33% | 2875 2013 Formulary | |||||
2014 SilverScript Basic (PDP) | $29.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $2.00 | 21% | 45% | 25% | |||||||
-- This plan not offered in 2013 -- | S0522 -038 | ||||||||||||||
-- | -- | -- | |||||||||||||
2014 Symphonix Value Rx (PDP) | $30.60 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $1.00 | $13.00 | $42.00 | $85.00 | 3382 2014 Formulary | ||||||
2013 United American - Select (PDP) | $33.70 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5755 -022 | $1.00 | $4.00 | $35.00 | $95.00 | 3131 2013 Formulary | |||||
2014 United American - Select (PDP) | $30.90 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $1.00 | $5.00 | $35.00 | $95.00 | 3184 2014 Formulary | ||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 Reader's Digest Value Rx (PDP) | $33.20 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S0128 -020 | $1.00 | $2.50 | $34.00 | 27% | 3112 2013 Formulary | |||||
new | new | new | |||||||||||||
2014 HealthMarkets Value Rx (PDP) | $31.20 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $0.00 | $2.00 | 25% | 40% | 3000 2014 Formulary | ||||||
2013 Aetna Medicare Rx Essentials (PDP) | $32.80 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5810 -053 | $2.00 | $20.00 | $45.00 | 41% | 3300 2013 Formulary | |||||
2014 Aetna Medicare Rx Essentials (PDP) | $31.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | $3.00 | $42.00 | $95.00 | 25% | 3017 2014 Formulary | ||||||
2013 SmartD Rx Saver (PDP) | $32.40 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S0064 -019 | $0.00 | $20.00 | $30.00 | $77.00 | 3178 2013 Formulary | |||||
2014 SmartD Rx Saver (PDP) | $31.70 | $310 | No additional gap coverage, only the Donut Hole Discount | Yes | tbd | ||||||||||
2013 EnvisionRxPlus Silver (PDP) | $27.30 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S7694 -019 | 25% | 25% | 23% | 28% | 2711 2013 Formulary | |||||
2014 EnvisionRxPlus Silver (PDP) | $32.50 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $5.00 | 25% | $45.00 | 45% | 2630 2014 Formulary | ||||||
2013 SilverScript Choice (PDP) | $29.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5601 -128 | $0.00 | $34.00 | 35% | 33% | 2875 2013 Formulary | |||||
2014 SilverScript Choice (PDP) | $33.80 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $24.00 | 35% | 33% | 0 | ||||||
2013 MedicareRx Rewards Standard (PDP) | $46.00 | $325 | No additional gap coverage, only the Donut Hole Discount | No | S5960 -125 | $2.00 | $7.00 | $29.00 | $85.00 | 2838 2013 Formulary | |||||
2014 MedicareRx Rewards Standard (PDP) | $37.60 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $1.00 | $3.00 | $34.00 | $87.00 | 2463 2014 Formulary | ||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 First Health Part D Value Plus (PDP) | $26.30 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5768 -142 | $0.00 | $35.00 | $70.00 | 33% | 3118 2013 Formulary | |||||
2014 First Health Part D Value Plus (PDP) | $40.70 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $3.00 | $11.00 | $37.00 | $88.00 | 3006 2014 Formulary | ||||||
-- This plan not offered in 2013 -- | S9579 -018 | ||||||||||||||
2014 Transamerica MedicareRx Classic (PDP) | $42.90 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $8.00 | $45.00 | $95.00 | 3032 2014 Formulary | ||||||
2013 AR Blue Cross - Medi-Pak Rx Basic (PDP) | $31.40 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5795 -003 | $4.00 | $11.00 | 20% | 31% | 2923 2013 Formulary | |||||
2014 AR Blue Cross - Medi-Pak Rx Basic (PDP) | $43.10 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $4.00 | $15.00 | 22% | 41% | 2839 2014 Formulary | ||||||
2013 AARP MedicareRx Preferred (PDP) | $40.30 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5820 -018 | $2.00 | $5.00 | $40.00 | $85.00 | 3829 2013 Formulary | |||||
2014 AARP MedicareRx Preferred (PDP) | $44.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $2.00 | $6.00 | $40.00 | $85.00 | 3707 2014 Formulary | ||||||
2013 Humana Enhanced (PDP) | $42.10 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5884 -077 | $2.00 | $5.00 | $38.00 | $90.00 | 3923 2013 Formulary | |||||
2014 Humana Enhanced (PDP) | $45.90 | $0 | Few Brands | No | $2.00 | $5.00 | $42.00 | $92.00 | 3745 2014 Formulary | ||||||
-- This plan not offered in 2013 -- | S5660 -212 | ||||||||||||||
2014 Express Scripts Medicare - Choice (PDP) | $49.60 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $2.00 | $9.00 | $40.00 | $90.00 | 3250 2014 Formulary | ||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 First Health Part D Premier (PDP) | $35.10 | $325 | No additional gap coverage, only the Donut Hole Discount | Yes | S5768 -043 | $3.00 | 25% | 45% | 3113 2013 Formulary | ||||||
2014 First Health Part D Essentials (PDP) | $51.80 | $310 | No additional gap coverage, only the Donut Hole Discount | No | $1.00 | 15% | 47% | 2981 2014 Formulary | |||||||
-- This plan not offered in 2013 -- | S9579 -051 | ||||||||||||||
2014 Transamerica MedicareRx Choice (PDP) | $52.20 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $20.00 | $45.00 | $95.00 | 3169 2014 Formulary | ||||||
2013 WellCare Extra (PDP) | $34.00 | $0 | Many Generics | No | S5967 -190 | $0.00 | 25% | 25% | 50% | 2835 2013 Formulary | |||||
2014 WellCare Extra (PDP) | $54.00 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $0.00 | $35.00 | $65.00 | 2844 2014 Formulary | ||||||
2013 United American - Enhanced (PDP) | $55.80 | $0 | No additional gap coverage, only the Donut Hole Discount | No | S5755 -106 | $1.00 | $7.00 | $40.00 | $95.00 | 3381 2013 Formulary | |||||
2014 United American - Enhanced (PDP) | $65.90 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $1.00 | $7.00 | $37.00 | $95.00 | 5136 2014 Formulary | ||||||
2013 SmartD Rx Plus (PDP) | $69.60 | $0 | Some Generics | No | S0064 -054 | $0.00 | $20.00 | $30.00 | $77.00 | 3178 2013 Formulary | |||||
2014 SmartD Rx Plus (PDP) | $66.30 | $0 | Call Plan for details | No | tbd | ||||||||||
-- This plan not offered in 2013 -- | S5617 -264 | ||||||||||||||
2014 Cigna Medicare Rx Secure-Xtra (PDP) | $69.70 | $0 | No additional gap coverage, only the Donut Hole Discount | No | $0.00 | $5.00 | $38.00 | $87.00 | 3618 2014 Formulary | ||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 First Health Part D Premier Plus (PDP) | $98.80 | $0 | Some Generics, Some Brands |
No | S5670 -102 | $0.00 | $20.00 | 25% | 43% | 3173 2013 Formulary | |||||
2014 First Health Part D Premier Plus (PDP) | $104.60 | $0 | Some Generics, Some Brands |
No | $1.00 | $25.00 | 25% | 43% | 3104 2014 Formulary | ||||||
2013 SilverScript Plus (PDP) | $91.20 | $0 | Many Generics, Some Brands |
No | S5601 -107 | $0.00 | $34.00 | 35% | 33% | 2875 2013 Formulary | |||||
2014 SilverScript Plus (PDP) | $108.80 | $0 | Many Generics, Some Brands |
No | $0.00 | $17.00 | $41.00 | 33% | 0 | ||||||
2013 Cigna Medicare Rx Plan Two (PDP) | $70.30 | $0 | Few Generics | No | S5617 -189 | $0.00 | $10.00 | $45.00 | $90.00 | 3657 2013 Formulary | |||||
2014 Cigna Medicare Rx Secure-Max (PDP) | $114.60 | $0 | Many Generics, Some Brands |
No | $0.00 | $4.00 | $25.00 | $74.00 | 3766 2014 Formulary | ||||||
2013 Aetna Medicare Rx Premier (PDP) | $93.20 | $0 | Many Generics, Some Brands |
No | S5810 -189 | $5.00 | $33.00 | $45.00 | tbd | 3364 2013 Formulary | |||||
2014 Aetna Medicare Rx Premier (PDP) | $114.70 | $0 | Few Generics | No | $6.00 | 23% | 45% | 33% | 3134 2014 Formulary | ||||||
2013 AR Blue Cross - Medi-Pak Rx Premier (PDP) | $88.80 | $0 | Many Generics, Few Brands |
No | S5795 -002 | $6.00 | $45.00 | $84.00 | 25% | 4885 2013 Formulary | |||||
2014 AR Blue Cross - Medi-Pak Rx Premier (PDP) | $119.20 | $0 | Many Generics | No | $3.00 | $15.00 | $45.00 | $90.00 | 3658 2014 Formulary | ||||||
2013 Humana Complete (PDP) | $113.90 | $0 | Some Generics, Some Brands |
No | S5884 -047 | $5.00 | $36.00 | $71.00 | 33% | 3937 2013 Formulary | |||||
-- Members will be assigned to Humana Enhanced (PDP) S5884-077 -- | |||||||||||||||
Plan Name | Monthly Premium |
Deduct- ible |
Additional Gap Coverage |
$0 Prem. Full LIS? |
Plan ID |
Cost-Sharing | Total Drugs | ||||||||
Service | Exper. | Cost Info | Tier 1 | Tier 2 | Tier 3 | Tier 4 | |||||||||
2013 Destiny Health MedSaver Part D Plan (PDP) | $35.80 | $325 | No additional gap coverage, only the Donut Hole Discount | No | S2978 -007 | 0 | |||||||||
new | new | new | |||||||||||||
-- This plan not offered in 2014 -- | |||||||||||||||
2013 EnvisionRxPlus Gold (PDP) | $54.00 | $150 | Some Generics | No | S7694 -089 | $2.00 | $5.00 | $25.00 | 30% | 2747 2013 Formulary | |||||
-- This plan not offered in 2014 -- | |||||||||||||||
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